Individual
ELISE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
312 WHITWELL DR, ROANOKE, VA 24019-2039
(540) 366-7399
Mailing address
645 ALBEMARLE AVE SE, ROANOKE, VA 24013-2327
(276) 920-4547
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001985
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133001985
VIRGINIA BOARD OF MEDICINE
VA
Enumeration date
09/23/2021
Last updated
09/23/2021
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